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Individual
MRS. SUSAN MARIA FREDERICK
Active
Individual
MRS. SUSAN MARIA FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP023628
PA
363LF0000X
Family Nurse Practitioner
Primary
33 333028
NY
Other
Enumeration date
08/15/2008
Last updated
02/05/2026
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